Larkana, a district comprising 1.5 million people, recently had an HIV outbreak which took the country by storm. This was, however, not the first time the district had such an outbreak.
The first major HIV outbreak occurred in 2003. At the time, 17 out of 175 people were found to be HIV positive, a survey revealed.
Prostitution and syringe sharing were identified as the main causes of the outbreak.
The virus spread because young boys were being sold for sex at musafir khanas (motels at truck stops) and cheap hotels, according to the “The HIV epidemic in Pakistan” by the Journal of the Pakistan Medical Association. A large number of brothels were operating in the city too.
Other than that, Larkana was replete with drug users who would reuse and share syringes and needles.
“A friend and two cousins of mine have died because of AIDS,” said a police constable from Larkana. “My friend was a drug user and he used to share a syringe with others, while both of my cousins were involved in transgender prostitution.”
At the time, some test facilities for HIV patients were available at the Chandka Medical College Hospital, Larkana. People mostly travelled to Karachi for other tests and treatment.
The government, however, didn’t take any action to curb the problem.
The second major outbreak occurred in 2016. Negligence in blood banks was identified as its cause by the Sindh AIDS Control Programme.
It was reported when a dialysis patient informed a physician-in-charge of the dialysis unit of his HIV seropositivity. The doctor then got all other dialysis patients tested for HIV too.
The National AIDS Control Programme (NACP) subsequently conducted its own investigation. It found out that dialysis patients were being screened using HIV rapid test kits from September 27, 2016, to October 8, 2016.
The name of the kit wasn’t even in the WHO approved list available with the programme.
As many as 56 of the 205 people tested positive for HIV. Twenty samples were selected at random and sent to the referral laboratory of the Sindh AIDS Control Programme in Karachi. The lab confirmed that 19 of the 20 people were HIV positive.
According to the programme’s report, there were 11 dialysis machines in Larkana hospitals.
There were only one medical specialist and one technician managing the dialysis machines in different shifts. Once the physician went, the on-duty technician managed the machines and the patients. Hospitals took some steps to control infections and they had no separate machines for people diagnosed with hepatitis B, hepatitis C and HIV.
“Patients who were going for dialysis were getting HIV viruses and it was all happening because of blood transfusion,” said the constable. Some of the blood banks were even supplying the blood with HIV viruses in them, he claimed.
During this time, an operation was launched against illegal blood banks and laboratories in the city. Four blood banks were sealed in Shahdadkot town, 16 in Qambar and three in Larkana.
The third outbreak was reported this year when a 14-year-old was found to be HIV positive.
Dr Imran Akbar, who unearthed the crisis, started advising all people to get their babies tested for HIV. Within 15 days, 20 children were found to be HIV positive. He reported the results to the Sindh AIDS Control Programme which then swung into action.
“More than 600 people have been found to be HIV positive,” he said, adding that the real figures may be in the thousands.
SSP Masood Bangash told SAMAA Digital that police have tracked down all brothels and they have been stopped from operating. “We just have to work hard to bust drug users now,” he said.
There are no rehabilitation centres in the entire district to help drug users, said SSP Bangash.
A drug user said that he wants to seek help but it is very difficult. “The policemen only detain us and beat us up, but we can’t get over our addiction till someone helps us,” he remarked.
The operations conducted by police created fear among prostitutes and drug users, said SSP Bangash, adding that as a result, they have now spread all over the district. The virus is also being found in children and newborns.